Articles: postoperative-pain.
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Regional anesthesia · Jul 1989
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of continuous epidural analgesia with sufentanil and bupivacaine during and after thoracic surgery on the plasma cortisol concentration and pain relief.
The effect of continuous epidural analgesia with bupivacaine 0.125% and sufentanil 0.83 micrograms.ml-1 on the plasma cortisol concentration and postoperative pain relief was compared with that of intermittent intravenous peroperative and on-demand intramuscular postoperative analgesia with nicomorphine 0.2 mg.kg-1. The study was performed on two groups of ten patients for three consecutive days after thoracic surgery. In the epidural group, a better quality of analgesia was found as measured with the Inverse Linear Analgesia Scale (ILAS) (1 = severe pain, 10 = no pain) than in the group that received intramuscular analgesia. ⋯ L-1 on day 1. The measured mean plasma cortisol concentration was found to exceed normal limits (150-700 nmol. L-1) only in the systemic group and only on day 1.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of the incidence of pruritus following epidural opioid administration in the parturient.
Epidural morphine is associated with a high incidence of pruritus when used for pain control in the post-Caesarean section population. The purpose of this study was to compare the incidence of pruritus associated with epidural morphine, fentanyl, buprenorphine and butorphanol. ⋯ This study demonstrated that the incidence of pruritus was significantly higher following the use of epidural morphine and fentanyl. Even though epidural butorphanol and buprenorphine exhibited a low incidence of pruritus, their duration of analgesia was not long enough to make either attractive for single-dose administration.
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Randomized Controlled Trial Clinical Trial
Transdermal fentanyl for the relief of pain after upper abdominal surgery.
Transdermal fentanyl (n = 22) was compared with placebo (n = 18) in a double-blind study of pain after upper abdominal surgery. All patients also received i.v. morphine on demand for supplementary analgesia. ⋯ After operation, pain scores were significantly lower and peak expiratory flow rates significantly higher in the transdermal fentanyl group, who demanded significantly less morphine than the control group. Mean plasma fentanyl concentrations at 12 and 24 h were within the therapeutic range (1.5 and 2.0 ng ml-1, respectively).